The Pursuit Of Happiness

Fiona O'Loughlin emerged out of Alice Springs some thirteen years ago as a 'fully formed' 36 year old stand up comedy sensation.

She wowed local and international audiences with unconventional stories of raising five children in the outback.

Then after collapsing on stage in Brisbane, she confessed she was an alcoholic. But behind the scenes, the drinking got worse.

In Monday's program, Ms O'Loughlin and those closest to her candidly confront the darkest demons of an issue that has famously bedevilled many male comedians, but is less acknowledged by women in the public eye.

It's been a tough road but she has just achieved her first year in recovery, and is back performing to sell out audiences. She's also returned to Alice and the family home she abandoned three years ago at the height of her problems.

Transcript

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The Pursuit Of Happiness - Transcript

EDDIE PERFECT, PRESENTER: Hi. I’m Eddie Perfect. Tonight’s show is all about fellow comic and great friend Fiona O'Loughlin. Fiona is a fearlessly courageous comedian: a real truth teller. She sees truth as being like that burning pot on the stove that you just can’t help but pick up with your bare hands, even though you know it’s going to hurt. She’s so courageous on stage, confronting some of her own personal demons very publicly, as you’ll see in tonight’s program. So this is her story.

(Footage of Fiona backstage, applying make-up before a performance)FIONA O'LOUGHLIN: This is the loneliest part of the whole career. Like, everything... I dread this more than anything. I just don’t know why this bit horrifies me so much.

LAWRENCE MOONEY, FRIEND AND COMEDIAN: When you look at Fiona’s story, it is an extraordinary story.

FIONA O'LOUGHLIN (holding up a pair of high-heeled shoes): And the real pain begins. (Laughs)

LAWRENCE MOONEY, FRIEND AND COMEDIAN: She comes from Alice Springs to start a career in what most people consider probably one of the most difficult jobs in the world: stand-up comedy.

FIONA O'LOUGHLIN (on stage): There’s a lot of you here, isn't there? I’m from Alice Springs. I’m not really used to people.

FIONA O'LOUGHLIN: I was 36, which is quite late, but I made a pact with myself that I was going to transport my dinner party self to the stage and tell stories.

FIONA O'LOUGHLIN (on stage): I could exercise but that’s time-consuming. This way I get to keep drinking and...

FIONA O'LOUGHLIN: You get this joy from the audience and it rebounds back to you. Yeah, everybody wins and you just ride that wave home, you know, and it’s a very addictive feeling.

(Footage of Fiona performing stand-up)FIONA O'LOUGHLIN: People say to me, "Oh my God, Fiona, how do you juggle it: five kids and an international comedy career?" I don’t. I leave them.(Audience laughs)(End of footage)

PAUL McDERMOTT, FRIEND AND COMEDIAN: It’s difficult to examine and dissect the minutiae of your own existence and offer it up as comedy and even darker and harder, I think, if you have other, deeper personal problems that you are touching on in that exploration.

(Footage of Fiona performing stand-up)FIONA O'LOUGHLIN: Can I please thank you so much once again for having me? Good night.(Audience applauds)(End of footage)

PRESENTER (ABC radio, Alice Springs): My next guest is a much-loved daughter of Alice Springs, albeit one that doesn’t really call home often enough, though.

FIONA O'LOUGHLIN: I’m a bit of a stick-your­-head-in-the-sand kind of person and that’s actually served me well at times, you know, when you’ve got to go on stage and something horrible has happened five minutes before. But it was time for me to, to come back.

TESS O’LOUGHLIN: I think it will be daunting for Mum, going back to Alice Springs. I mean, she left in such a hurry, with no real plan.

CATE TAYLOR, SISTER: She’ll probably find it more confronting than she realises. I think it will be very hard for her to see her house and to see changes and to see people. A lot of not going back was because she was embarrassed.

LAWRENCE MOONEY, FRIEND AND COMEDIAN: When I think about Fiona, the peril of alcohol is ever-present. And people always ask you when you arrive, "Do you want a drink?" That doesn’t happen in most jobs, does it? (Laughs) You know, if you’re a brain surgeon: "Do you want to have a beer to just take the edge off before we get started?"

FIONA O'LOUGHLIN (Melbourne International Comedy Festival (MICF), 2002): So I pick them all up from school on Friday afternoons, then Mummy likes to go to Liquorland.

LAWRENCE MOONEY, FRIEND AND COMEDIAN: Alcoholism can often be talked about quite lightly.

FIONA O'LOUGHLIN (Melbourne International Comedy Festival, 2002): I left the baby at Liquorland. (Audience laughs) Now I would have gone back for him... (Audience laughs)

LAWRENCE MOONEY, FRIEND AND COMEDIAN: And oh, isn’t it fun? Aren’t we crazy? And at the end of the day it kills. And when Fiona started to fall down, literally, word spreads very quickly through the comedy world.

FIONA O'LOUGHLIN: I knew I was an alcoholic but I hadn’t told anyone and that’s what led me to be so out of control, you know. And I almost had to hand myself in.

FIONA O'LOUGHLIN (Melbourne International Comedy Festival, 2010): It’s a slow progression, alcoholism. You know, I just used to be a bit loud at dinner parties.

PAUL McDERMOTT, FRIEND AND COMEDIAN (voiceover): I think Fiona’s been gutsy for talking about her alcoholism.

FIONA O'LOUGHLIN (Melbourne International Comedy Festival, 2010): And in any relationship there’s the chattier one, the one that wants to stay a bit longer and talk a bit more and just have one more glass of champagne, "and I’ll just finish this story"... and the other one drives.

PAUL MCDERMOTT, FRIEND AND COMEDIAN: It’s hard, It’s difficult and it’s... You know, it’s to be applauded and people are going to... People are going to have – doesn’t matter who you are, you are going to have difficulties.

FIONA O'LOUGHLIN: I grew up in a very small town in South Australia; in a place called Warooka.

DEIRDRE TAHENY, MOTHER: We’ve got seven children and Fiona was the third. Fiona was always the one who liked the limelight, I suppose.

DENIS TAHENY, FATHER: And you could notice, too: if we had friends here and they were telling a good story, Fiona would be very intense, listening.

FIONA O'LOUGHLIN: Chris and I were very young when we married. I was 22 and he was 24. So we moved to Alice Springs and had three children pretty quickly, three under three: Henry, Biddy and Tess. And then we had a five-year gap and had Albert, known as Bert, and Mary Agnes Guinevere.

CATE TAYLOR, SISTER: And it was actually Chris’s sister Jude who dubbed it "The Land Of Do As You Please". It was kids' paradise. My kids loved going to their house. It was so much fun.

TESS O’LOUGHLIN: They weren't very strict parents, but I think it helped that all of us kids never were really out of line at all. We were all very well-behaved and I think that helped them being pretty-laid back parents.

CATE TAYLOR, SISTER: Their house was such a fun hub of, you know, entertainment. And that’s how I met my husband: he was playing poker around there at 11 o’clock in the morning and the baby was in the playpen and she was holding court with, you know, four men playing poker. She loved cards, yeah.

FIONA O'LOUGHLIN (singing to the tune of I Am Woman): I am woman, hear me roar/In accents too broad to ignore/And you'd swear that I was born in the USA...

FIONA O'LOUGHLIN (singing): But I’m an Aussie through and through/And I can prove that now to you/Because I drink a can of XXXX everyday...

FIONA O'LOUGHLIN: But I really wanted to perform and had always wanted to perform.

FIONA O'LOUGHLIN (Stateline, ABC TV, 1996): And I won’t have fun until I’ve got that mike and I've got them to laugh at my first joke. Then I’ll have fun. I'll come home...

CATE TAYLOR, SISTER: When she did decide, you know: "Actually I can make people laugh. Maybe that’s the way I can, you know, get out of being a housewife" and she got this grant to go to Melbourne, I went with her. And she got up and she did five minutes and I remember thinking, "That was terrible."

FIONA O'LOUGHLIN: You know, I’ve just come off beaming off stage, having done a very ordinary performance, but I knew enough to know that there’s a seed there. You know, I didn’t get booed off.

FIONA O'LOUGHLIN (archive): I’ve got another gig after this. In July.

TESS O’LOUGHLIN: Dad was very supportive of Mum's, I guess, dream of becoming a comedian. He actually managed her in the beginning and he was extremely supportive.

PAUL McDERMOTT, FRIEND AND COMEDIAN: Fiona seemed to hatch fully formed out of Alice Springs.

FIONA O'LOUGHLIN: And then all of a sudden you find yourself in Montreal.

FIONA O'LOUGHLIN (Montreal Comedy Festival, 2007): I’ve got five children. You know, I couldn’t tell you all their names off the top of my head right now 'cause I drink like a fish. But... (Audience laughs)

TESS O’LOUGHLIN: Whenever anyone found out that Fiona O'Loughlin was um, my mother, it was the first thing that they'd always say: it was like, "Oh, the one that pays out her kids."

FIONA O'LOUGHLIN (Montreal Comedy Festival, 2007): It’s an awful lot of kids, isn't it in this day and age, five kids, but we’re committed. We’re going to keep trying 'til we get one we like.

TESS O’LOUGHLIN: My older brother and my older sister got a bit more than me and I remember once that I actually got quite angry that I was never talked about on stage.

FIONA O'LOUGHLIN (Montreal Comedy Festival, 2007): Mothers have this policy line, you know: "We don’t have any favourites. We love you all the same." Oh my God. That’s not actually true. Bad mum, drinking too much, don’t like your kids, you know: I performed that shtick pretty well. But I’m not necessarily that proud of it now. It was very hard to bitch about kids that you actually adore.

FIONA O'LOUGHLIN (Montreal Comedy Festival, 2007): We have to have a family reunion every two years just to ward against incest.

PAUL McDERMOTT, FRIEND AND COMEDIAN: Fiona, of course, has played major festivals. And you’re in this weird limbo, away from the world for four or five weeks, just hermetically sealed in a fun palace of idiocy. There’s certainly a lot of drinking goes on, a lot of carousing and a lot of mindless pursuit of happiness.

FIONA O'LOUGHLIN: Even if you’re a middle aged woman you’re still part of the festival so, you know: Hey, it’s the festival! You know, it’s a real disclaimer for bad behaviour.

CATE TAYLOR, SISTER: And we all knew she drank too much but we just thought it was binge drinking. But she seemed to have to drink. If she had a good show, she’d drink to celebrate. If she had a bad show, she’d drink to drown her sorrows. So...

FIONA O'LOUGHLIN: My whole story is my alcoholism is linked to my performance.

FIONA O'LOUGHLIN (Montreal Comedy Festival, 2007): Frees me up for a bit more gin and tonic.

FIONA O'LOUGHLIN: I had never, ever gone on stage without two of those little vodkas that you get from mini bars in your hotel room. I think I had the gene. And I think with Dad: alcoholism is very strong in his family. He’s not an alcoholic but, you know, you poke that tiger long enough it will rise up and you’re on the other side and you can’t ever come back from the other side, you know.

PAUL McDERMOTT (The Sideshow, ABC TV, 2007): Would you please be upstanding for the queen of Australian stand-up, the wonderful Fiona O’Loughlin. (Audience applauds)

PAUL McDERMOTT, FRIEND AND COMEDIAN: You may have everything on stage down pat but your life around it can be absolute chaos.

FIONA O'LOUGHLIN: So I was away more and more and Chris was at home, looking after the kids. Living between these two extreme lives was getting harder and harder and, at the same time, my drinking was starting to take its toll.

TESS O’LOUGHLIN: My first indication that there was a problem with Mum was when she did start to miss flights coming home. And the reason that she would miss flights coming home was because she didn't want us to see her in that state.

CATE TAYLOR, SISTER: And we didn’t know where she was. And usually it was because she’d had a big night and she slept in or ended up somewhere where she shouldn’t have been. And that’s when we started worrying.

LAWRENCE MOONEY, FRIEND AND COMEDIAN: When you’re that drunk that it’s showing up on stage and you’re collapsing, you know, not turning up to gigs or being on shows pissed, that’s just going to end up in a car crash.

FIONA O'LOUGHLIN: You know, the public rock bottom was Brisbane Queensland Performing Arts Centre, when I did literally pass out on stage. And immediately after that, someone said, "Let’s just tell the media you’re exhausted." And I said, "No. Let’s tell the media that I’m an alcoholic because that’s the truth." And I had an overwhelming sense of relief. And maybe I should have felt more embarrassed – I felt very bad for the people in the audience.

CATE TAYLOR, SISTER: People were furious. People wanted their money back. And I think as soon as she did come out and say she was an alcoholic, she regretted it because it meant she really had to start behaving.

FIONA O'LOUGHLIN (Melbourne International Comedy Festival, 2010): I woke up one morning, right. And I've... you know, and everything comes back to you. What you've done...

FIONA O'LOUGHLIN: I wonder sometimes if it was the smartest move to go so public with my alcoholism because, you know, I set myself up for a lot of falls.

FIONA O'LOUGHLIN (Melbourne International Comedy Festival, 2010): Anyway, my husband goes, "Are you getting up?" And I went, "No. I’m never getting up. I’m so embarrassed. I’m never, ever, ever getting up. This is my death bed." And my husband said to me - and I kid you not - he said, "Well, it may well be your death bed but at the moment it’s our kitchen table and we...

(Audience laughs and applauds)

FIONA O'LOUGHLIN: Things almost got worse after I went public. You know, I went to rehab. But I was still carrying so many secrets that an addict carries. So it was the beginning of a very long road.

FIONA O'LOUGHLIN: I had the deepest, darkest secrets. See, I’d told the world that I’d stopped drinking.

FIONA O'LOUGHLIN (Melbourne International Comedy Festival, 2010): Now, here’s the thing: I am an alcoholic which means, sadly for me, that I can never drink again for ever. The real kicker is that I’m also Catholic and married, (Audience laughs) which is also for ever. And now I have to do him sober. (Audience laughs)

FIONA O'LOUGHLIN: And indeed I had stopped drinking in any social environment. But I was convinced that if I went on stage without those two little vodkas inside of me, I would let the whole thing down. Everyone will find out that I’m a fraud. I can’t do it because I’ve never done it without it. And that was just hell. You know, I used to suffer terribly from self-loathing. So I was really leading a very double life. I’d never regret marrying Chris in a million years. But towards the end of living in Alice Springs, I knew I couldn’t get sober there. The problem is that Chris and I weren’t able to be there for each other. Like, an alcoholic: oh my God, the pain you cause. My husband and I were arguing on our way to the airport for yet another gig and I broke. I just said I’m – just in my head I just thought, I’m never coming back. And I only had a little carry bag with me.

TESS O’LOUGHLIN: For the two younger kids, Bert and Mary, I can see how confused they were at the time. But for Henry, Biddy and myself, I think we all agreed that it was a much healthier decision for Mum to leave Alice Springs and for Mum and Dad to go their separate ways.

CATE TAYLOR, SISTER: I was surprised that the kids moved to Melbourne with her because she really wasn’t in a fit state to look after herself, let alone her children. She’d been falling off the wagon more and more and her daughter Tess had a couple of times found her almost unconscious in a park.

TESS O’LOUGHLIN: There's just so much anger in you towards this person. And then, you know, the following days she's so upset and you don't - because she's so ashamed of what she's done. And then you kind of look at her and you feel so sorry. And you do realise that it's two completely separate people.

FIONA O'LOUGHLIN: The pain in your children’s face when they know you’ve been- when they know you’ve fallen off the wagon is unbearable. And so I thought the only - and I believed that I only had one solution: and that was to kill myself.

CATE TAYLOR, SISTER: She checked herself into a hotel under a different name and she took an overdose.

LAWRENCE MOONEY, FRIEND AND COMEDIAN: At the beginning of last year when Fiona was hospitalised and her, you know, life was in danger, there was a cloak that gathered around her very quickly. I went to visit her and she was, um... she was very alone.

PAUL McDERMOTT, FRIEND AND COMEDIAN: You know, a lot of people were actively trying to help. But sometimes until... until the focus of that attention understands that, you know, everyone else can only do so much...

TESS O’LOUGHLIN: That was kind of my turning point as well as hers. I'd made the decision to quit uni and move overseas because I thought, I can't help her anymore. I came to the realisation that it's not up to us: it's up to her. And there's nothing that we can do that will make her stop.

CATE TAYLOR, SISTER: Fortunately, this time it all - like, she was under a psychiatrist who seemed to work for her. But it was at that time that I said to her, "It’s got to stop now."

DR MARK JOHNSON, FIONA’S PSYCHIATRIST: Well, we know that alcoholism like other addictions is a chronic and relapsing condition. And people can take a long time to not just acknowledge the problem but actually be ready to effectively engage in treatment. And I think that was the case with Fiona.

FIONA O'LOUGHLIN: It was August last year. I was about to do a gig in Mackay. I had performed the night before. My manager knew that I’d been drinking and he cried before I went on stage. He begged and I surrendered. I just said, "OK." But I thought: you’ll find out. I’ll be rubbish onstage, but let’s do it. I was tired. I was like, OK, you win. I’ll do the show without my two vodkas and it will be terrible and you’ll all find out what a fraud I am. And I went onstage that night and obviously I was not in a very happy place at all. But Dr Footlights kicked in and, you know, I’ve been doing stand-up for a long time, so I just did my stand-up. And, and it worked. (Laughs) It was a really good show. And the relief of that! And then I started exploring: you know, I couldn’t wait for the next gig.

FIONA O'LOUGHLIN (Melbourne International Comedy Festival, March): She’s halfway through cutting my hair and she said, "Do you have any grandchildren?" And I said, "No. We decided against them in the end." (Audience laughs) And she said, "Oh, cool." (Audience laughs) And I thought: wouldn’t it be delicious to be that dumb? Thank you so much. Good night. (Audience applauds)

DR MARK JOHNSON, FIONA’S PSYCHIATRIST: She also, from August of last year, agreed to be trialled on Antabuse, which is a drinking aversion medication. And she received that from the clinic here twice a week until earlier this year.

FIONA O'LOUGHLIN: Pretty excited today because I’m seeing my psychiatrist and it’s the first time I’ve seen him since I’ve hit the 12-month mark. And I’m sure - like, they don’t act excited, you know, because they’re the professional but there's got to be some element: I’m sure that they get a bit of a kick out of, you know, their patients' success.

DR MARK JOHNSON, FIONA’S PSYCHIATRIST: I’m very pleased and proud when people make that kind of progress, usually with a lot of effort. But I also have to temper that with not having them believe that they can’t tell me if they’ve lapsed or relapsed for fear of disappointing me.

PRESENTER (ABC radio, Alice Springs): Comedienne Fiona O’Loughlin is back in town at the moment. Welcome back, Fiona!

FIONA O'LOUGHLIN (ABC radio, Alice Springs): Yeah. I get really nervous in Alice because I know so many people.

FIONA O'LOUGHLIN: It’s been three years. It’s definitely time to go back. You can’t just walk out of a life and have no closure. I don’t dwell on it much but I think it would be... You know, I’m looking forward to it and I'm terrified of it at the same time.

(Footage of Fiona approaching her old house, fighting tears. She laughs as the dog barks inside the front door)

FIONA O'LOUGHLIN: Walking into the house was very emotional. There was no one home except for the dog. There’s something about this house. We’ve all loved it. I was very impressed by how tidy the house was. And it does have Chris’ mark on it now and it isn’t my house. And I’m really OK with that.

FIONA O'LOUGHLIN (inside family home): Oh, my photos. Thank God. (Cries) It’s actually like stepping back into another world. They’re just photos of before everything changed so much.

FIONA O'LOUGHLIN: Chris since the beginning of my career has chosen never to be on camera. That’s his choice. But I just long to get to the stage where we’re friends. And he’s been a really good bloke. And yeah, we are friends again, you know.

FIONA O'LOUGHLIN (inside family home): I don’t think I could have stayed. I know now, seeing the house.

(Fiona leaves the house)

CATE TAYLOR, SISTER: She’ll want to show Alice Springs that she’s doing well and that she still loves the town. She was very fortunate to live there when she did or it wouldn’t have- her career wouldn’t have taken off like it did, I don’t think.

FIONA O'LOUGHLIN (backstage, showing photo book): Yeah, so that photo there was me. And I reckon it was 20 years ago. But it was in this very dressing room

MASTER OF CEREMONIES (Araluen Arts Centre, September): I’m told it’s been three years since Fiona has performed in Alice Springs. Please give her a very warm welcome: Fiona O’Loughlin!

FIONA O'LOUGHLIN (Araluen Arts Centre): This is great. It's a comedy show and I'm about to burst into tears.

LAWRENCE MOONEY, FRIEND AND COMEDIAN: ... and afterwards there’s not that loathing there.

FIONA O'LOUGHLIN (Araluen Arts Centre): Yeah, there’s a bit to tell you. I’m 50 now- well, 51. When you get to 50, well, you’re f***ed but it’s in the very best way.

LAWRENCE MOONEY, FRIEND AND COMEDIAN: And sure she would have burned some bridges...

FIONA O'LOUGHLIN (Araluen Arts Centre): I think I'll just annoy people for the rest of my life. I don't know what I'll do...

LAWRENCE MOONEY, FRIEND AND COMEDIAN: ... and I can understand a level of anger. But to write her off shows no empathy and no compassion in a way.

FIONA O'LOUGHLIN (Araluen Arts Centre): I had words but unfortunately I couldn’t weave them into sentences.

LAWRENCE MOONEY, FRIEND AND COMEDIAN: You’ve got to give somebody a chance to stand up again and have another crack.

FIONA O'LOUGHLIN (Araluen Arts Centre): Thank you so much for having me. Good night, Alice Springs. (Audience applauds)

LAWRENCE MOONEY, FRIEND AND COMEDIAN: This may be the most successful time in her life. She’s kind of reborn - and I know that’s a problematic phrase - but she’s starting again.

FIONA O'LOUGHLIN (backstage): So good to see you again.

FRIEND (backstage): You look fantastic.

FIONA O'LOUGHLIN (backstage): Oh, I feel good.

DR MARK JOHNSON, FIONA’S PSYCHIATRIST: She is subject to constant temptation. She has to just keep remembering how much better her life is now sober than it was before when she was drinking.

CATE TAYLOR, SISTER: I think with Fiona, we’ll always be worried that she may fall off the wagon again. But we’re also more hopeful and more excited about her future. I can see her being an eccentric old lady now with a cat, playing cards 'til midnight.

TESS O’LOUGHLIN: I’m very proud of how far she’s come. After all the heartache that we went through with Mum, the good times definitely outweighed all the bad.

FIONA O'LOUGHLIN: I don’t hope so much to be an inspiration, but I do hope I’m a dire warning. And If you are an alcoholic: the reason we need to clean up our act is because we really do make life nearly unbearable for our loved ones. I’ve had far too many shoulders that I could lean on than a girl deserves, but I’m so grateful.

END CAPTIONS: Fiona O’Loughlin's two youngest children are living with her in Melbourne and her eldest daughter lives nearby. Her oldest son is in the Northern Territory and Tess O’Loughlin will return from London soon.

Alcohol is pretty much our favourite recreational drug in Australia. It’s not much different from other parts of the world, particularly the western world. So you know it’s only second only to smoking in terms of harms to the community. It’s a drug that we see in clinical practice. I mean most of my work is with alcohol use disorders so about 50% to 60% of what we see in a clinical setting is around alcohol. So yeah it’s it’s a big ticket item I guess and while there are specific harms from other drugs, particularly illicit drugs, they’re dwarfed by in terms of the health burden by alcohol and particularly by alcohol and cigarettes.

So the reason that alcohol’s so prevalent is because it’s a legal drug, it’s part of most people’s upbringing that they see alcohol, that it’s it’s sold to us through sports sponsorship and so forth, that it’s a rite of passage for many young people unfortunately and so really it’s it’s ubiquitous in our society. It’s considered necessary for recreation and it’s very readily purchasable of course. There’s a lot of alcohol outlets. We haven’t had the same public health campaigns around alcohol perhaps compared to smoking. So we’ve done some really great things with smoking cigarettes and reduced smoking rates substantially. We haven’t really moved on alcohol.

I think alcoholism is a complex topic and it’s a complex disorder and I call it a disorder. The reason being it’s influenced by a whole lot of factors. I mean you’ll get alcohol used more prevalent in a society like Australia because we have bottle shops on every corner. You may not get that sort of density of outlets in other parts of the world. But I would call it a disorder, perhaps a disease but I prefer disorder and it’s a biopsychosocial social condition. There’s a biological component so there’s a genetic loading and there are also changes that occur when you drink chronically. There’s psychological factors and of course the social setting that you’re in influences alcohol use. So it’s complex and there’s a number of factors and some people start drinking very young and and clearly demonstrate loss of control and they maybe have a large biological loading but they’re also going to have some psychological and social contributors. And there are other people who start a bit later so they may drink socially up until even middle age or later, then the amount escalates substantially and they get into real strife. So there’s a number of different causes put forward for alcohol use. There’s an argument that all substance use and addiction is a choice. I think that’s got some currency in the United States but I’m not sure that I necessarily buy that argument. I think there’s a choice involved but there’s also significant biological or physical or medical components in in addiction to alcohol and other drugs.

Some people seem to demonstrate loss of control with alcohol very early in their life and it’s very clear that they’ve got loss of control and that might be the cause of a genetic component and sometimes when you speak to people with very obvious loss of control from early contacts with alcohol they have a family history which is consistent with there being a genetic component to this, their drinking behaviour. But there’s also factors such as you know what do your peers do? So if everyone around you drinks a lot and sometimes certain professions alcohol traditionally has been a very strong part of the industry or the profession that people are in, or if you’re in a situation of social disadvantage where your understanding of health and the consequences of certain drug use like an alcohol use are not necessarily really strong, I think those factors can influence the way you drink as well. So there’s a number of factors and and I think they come together in people who have got alcoholism or a disorder of alcohol use in a sort of perfect storm that leads them into treatment or leads them into strife.

I guess what we need to understand is that addiction to alcohol or any other drugs is usually referred to as a relapsing remitting disorder. It’s a chronic disease or a chronic disorder that is characterised by flare ups. So it’s actually quite unusual sadly or unfortunately that somebody goes into treatment for the first time, the first contact with a treatment service or a rehabilitation service and gets better and it better for the rest of their life. It’s more often that eople have multiple attempts at trying to stop using drugs or alcohol. The classic one is smoking and we’ve seen public health around it takes multiple tries to get up cigarettes. I mean it’s no different for alcohol or other drugs. It might take a few goes before you’re ready or engaged enough to realise that and really progress and change.

So it’s not unusual for somebody to go to rehab and find their disorder doesn’t quite respond or they don’t recover after the first engagement with rehab and that’s not a reason not to go into treatment or not to seek treatment. I think I believe treatment’s effective for alcohol use disorders. I think it works. But it may be that it takes in some cases a few goes at it.

Alcohol treatment’s usually a process and it involves a number of treatment modalities. So quite often somebody who’s very alcohol dependent might need to have that acute issue treated so that might mean you know the classic idea of detoxification. So detoxification is a medically managed process that goes for a few days and it’s fairly straight forward. The hard work probably comes after that detoxification and that might be support through a live-in rehabilitation centre or it might be ongoing counselling and that can be supported by some medications. We’ve got reasonably good medications to support other modalities of treatment like counselling. I think the message about alcohol treatment is it’s a long process and usually people don’t develop alcohol problems overnight. By the time they get to treatment it’s usually an entrenched disorder. I mean some people do come to treatment early and that’s great but most people will come when they’re really in trouble and that’s the nature of my work really, seeing people who are in great difficultly and it’s going to take a while for those people to get better.

I mean alcohol has a huge impact on families. We hear a lot about illicit drugs and psychostimulant drugs causing disruption to families, causing violence. Family violence disruption of families is is really prevalent in people that use alcohol at harmful levels. It’s really a big factor to family disruption. And families come often with their loved ones who have got an alcohol problem quite desperate actually. They’re very much at their wits end and they understandably want something done definitively early and straight away and that’s fair enough. As I said it often takes a few goes to to get people into a robust recovery. We have very limited ability around this country and in most parts of the world in fact to enforce treatment on people. So that’s where it becomes complex and where the behavioural issues and the issues around choice enter into treatment is that we need to be able to engage somebody in what’s a voluntary process. If somebody doesn’t take their diabetes medication and eats a lot of junk food, their diabetes will get worse and we want to change their behaviour. It’s not so dissimilar from alcoholism where we want people to engage with treatment, take medication, attend their counselling and support sessions and so forth. So families can get incredibly frustrated and prevalence to alcohol means that it disrupts huge numbers of families.

Look relapse is a part of alcohol use disorders. I mean it’s probably the rule rather than the exception in alcohol use disorders that people will at some time experience exposure to alcohol and despite the very negative consequences of past use they reuse. That can come at any time. Sometimes when people enter treatment they’re a bit ambivalent about treatment so they come into treatment thinking well I don’t know about this treatment thing, maybe this is for me, maybe this will help me, maybe it’s my family are pushing me into something that they’ve overstated. Denial and under reporting of alcohol use is not uncommon. So when people come into treatment maybe they’re not quite ready and in that group we often see people initially be a bit shaky before they come good. But you know people can relapse very late after many years and even decades of abstinence from alcohol where that’s been a treatment goal to get abstinence. So it it can happen at any time. People are at some risk if they’re continuing to drink but for other people continuing to drink is the only option. There’s a couple of approaches to treatment. One is managed drinking or controlled drinking or social drinking and the other approach is around abstinence. The abstinence model is very much the 12 step model which is popular in the United States and it it certainly works well. Obviously if you don’t drink alcohol you can’t get into strife from alcohol whereas if you’re counting your drinks there’s always a possibility that you’re going to escalate and it’s going to become chronic again. We work with people and what is realistic for them. Relapse is certainly a common outcome of early treatment and it can happen even in late in your alcoholic career when you’ve been abstinent or controlled in your intake for many years.

The abstinence model is probably not as popular in this country as it is in North America and and perhaps growing a bit in the places like the United Kingdom. It’s clearly a model that has great benefit for some people. It seems like in some people because of that biological component that drinking triggers neurochemicals, chemicals in your brain and there’s a really rapid progression to loss of control. So I think for a lot of people that abstinence is probably the ideal modality or treatment goal, abstinence makes a lot of sense when you’ve got a biological disease that’s triggered by neurochemical changes in the body that can be brought on by a a chemical like alcohol. But sometimes we’ve got to work with people where in this society where alcohol is so incredibly ubiquitous, it’s around us everywhere there’s alcohol outlets on every corner and it’s a very large part of socialising in Australia, sometimes we’ve got to work with that and just say well look can we reduce your intake. It depends on the severity I guess and alcohol use disorders are considered to be you know from mild to very bad or severe and it depends on the severity. It usually is somebody who’s in huge chaos and their alcohol use has caused substantial impact on their lives we would probably be encouraging a break and abstinence from alcohol.

Alcohol is a drug that effects a number of body systems from the central nervous system through to skin, through to the gut. It’s a carcinogen, it causes cancer so it’s got a very broad range of harmful effects in high dose long term use. It also has a number of effects obviously on on behaviour so people will self-harm when they’re intoxicated. They become disinhibited and they lose control and lose rational thinking when they’re intoxicated and that’s the time when people might do things that they wouldn’t normally do when they’re sober. There’s a high incidence of self-harm, there’s a high incidence of behaviours that are very risky so you know we’ve got a huge campaign in this country around driving over the legal alcohol limit and that’s because alcohol impairs one’s ability to operate machinery and drive a motor vehicle. Particularly young people jump in cars when they shouldn’t. People get into fights and so there’s a number of ways you can injure yourself in a drinking situation and particularly young people are are predisposed to those sorts of injuries.

In my view I think somebody coming out about their alcohol use, especially somebody in a position of influence or someone prominent, can’t be a bad thing. I really do think it’s a particularly American phenomenon that people will redeem themselves by admitting their their flaws and faults and and making amends and and talking about their alcoholism. I think it’s a really powerful message about caution, about this can happen to anyone, about you know just because you’re prominent, wealthy, seemingly bright and motivated and ah successful that it doesn’t mean you can’t be affected by alcohol. So I think it’s a good thing when somebody comes out and talks about their alcohol use. It’s a very stigmatised condition and if somebody who hasn’t got a whole lot of resources around them doesn’t feel they can talk about it, it’s going to be very hard for somebody who’s who’s hiding it, who’s family are very angry about it and I think somebody as an example is great. We get a lot of examples in the media about people who are happily drinking alcohol and there’s a lot of messages around alcohol and other drugs that are that sell it as being good fun and admittedly for some people it is, but I think we don’t get enough messages about people who’ve been harmed from alcohol and I think it’s traditionally something that people keep to themselves. We’ve had a lot of movement around mental illness and people talking about depression including people in who are very prominent in the community and I think that’s only just starting I think we’re a bit behind and it’s only just starting to happen with alcohol and other drugs.

I think alcohol probably is one of the drugs which people are perhaps a bit more willing to talk about because it’s a legal drug and it’s a drug that’s so prominent and affects so many people that we should be talking about. It may be a bit harder I think for people to come out and talk about illicit drugs or drugs that don’t have so much social approval as alcohol. I think in either case it’s pretty difficult for somebody to to admit that they’re flawed, that they can’t control this drug which everybody seems to use or or purports to use in moderation.

I think men are over-represented in our alcohol numbers, there are more men in harmful drinkers than there are women at least in our household surveys that follow these things. So men are more highly represented than women in as having alcohol use problems. I think for men alcohol use is considered masculine. It’s considered a rite of passage. It’s considered something that men can do and they can vomit and they can fall over and it’s actually a cool thing to do for men. Whereas for women I think it’s still considered a bit more distasteful when a woman drinks too much. So for that reason I think women perhaps are a bit more prone to hide their alcohol use. Men certainly have shame and hide their alcohol use but I suspect it’s a bit more difficult for women to admit that they get drunk or they drink too much and they behave strangely because they’re open to all sorts of accusations around their morals and around their behaviour as a woman where women are held up to this standard of different behaviour to men. So it to can be quite difficult for women.

I guess my main message is that alcohol is a huge part of what it constitutes drug treatment. I mean drug treatment isn’t just illicit drugs. Most of our work in drug treatment is around alcohol. It’s such a popular drug and it is a drug, it’s not just a drink, it is a drug, we see tonnes of people with alcohol use disorders. It’s a very large part of our work and while it doesn’t have the kind of illicit glamour or the illicit cache of drugs like methamphetamine it still remains really the bread and butter of treatment and the bread and butter of presentations to our emergency departments, the bread and butter of family violence and and trauma and fights, all of those sorts of things. Sometimes in combination with other drugs, but it still remains our number one drug problem in this country.